What should be done with a port‑a‑catheter needle when it is not in use?

Management of Port-a-Catheter Needles When Not in Use

Port-a-catheter needles should be replaced at least once per week when the port is being used for continuous or frequent infusions, and must be removed completely when the port is not actively in use. 1

When the Port Is Actively Being Used for Infusions

Weekly Needle Replacement Protocol

• Replace the Huber needle at minimum every 7 days during continuous or frequent infusion therapy (such as home parenteral nutrition or protracted chemotherapy regimens). 1
• This weekly replacement schedule allows patients the opportunity to safely bathe or shower after needle removal and before reinsertion. 1
• The needle replacement interval balances infection risk against patient quality of life and skin trauma from repeated access. 1

Evidence for Extended Needle Dwell Time

• Research from continuous infusion chemotherapy protocols demonstrates that Huber needles can remain in place for extended periods (mean 28 days, range 1-49 days) without catheter infections, local irritation, or thrombus formation when strict aseptic technique is maintained. 2
• However, guideline-level recommendations prioritize the more conservative weekly replacement schedule to minimize infection risk, particularly for home parenteral nutrition where the CDC considers this an unresolved issue requiring cautious practice. 1

When the Port Is Not Actively in Use

Complete Needle Removal Required

• Remove the needle entirely when the port is not being accessed for infusions. 1
• The port should never be left accessed with a needle in place during periods of non-use—this is fundamentally different from maintaining patency of the catheter itself. 1

Maintenance Flushing Schedule

• After needle removal, flush the port with normal saline every 4 weeks (monthly) to maintain catheter patency during inactive periods. 3
• Normal saline alone is sufficient; heparin provides no demonstrable advantage for port patency maintenance. 3
• This monthly schedule is less frequent than the weekly flushing required for tunneled catheters or PICCs, reflecting the lower infection and occlusion risk of fully implanted ports. 3

Critical Safety Principles

Infection Prevention During Access

• Scrub the port septum with alcoholic chlorhexidine or 70% alcohol for at least 15 seconds before needle insertion. 1
• Use only sterile Huber needles specifically designed for port access to prevent septum coring and damage. 1
• Maintain strict aseptic technique throughout all port manipulations. 1

Post-Use Flushing Protocol

• Always flush with normal saline immediately after any infusion, blood draw, transfusion, or parenteral nutrition to prevent medication precipitation and maintain lumen patency. 3
• Verify blood return before flushing to confirm catheter patency. 3

Protection of the Access Site

• Never submerge the accessed port unprotected in water—use waterproof dressings if showering is necessary while the needle is in place. 1
• The port site and needle should be protected with appropriate sterile dressings changed according to institutional protocols. 1

Common Pitfalls to Avoid

• Do not leave needles in place "just in case" during periods when the port is not actively needed—this increases infection risk without benefit. 1
• Do not use heparin locks routinely—normal saline is equally effective and avoids heparin-related complications including biofilm formation that increases infection risk. 1, 3
• Do not use syringes smaller than 10 mL for flushing—smaller syringes generate excessive pressure that can damage the catheter. 3
• Never recap or resheath needles after removal—dispose immediately into an approved sharps container at the point of use. 1